Provider Demographics
NPI:1508241415
Name:BRUCE, NORSHERN (FNP)
Entity type:Individual
Prefix:
First Name:NORSHERN
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13782B SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-7418
Mailing Address - Country:US
Mailing Address - Phone:225-313-8714
Mailing Address - Fax:225-523-7033
Practice Address - Street 1:8369 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7862
Practice Address - Country:US
Practice Address - Phone:225-380-5277
Practice Address - Fax:225-523-7033
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129757363L00000X
LAAP08312363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2454781Medicaid